OCTAVIA M NIGHTINGALE (NPI# 1225639826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225639826 |
| Entity Type | Individual |
| Full Name | OCTAVIA M NIGHTINGALE |
| Practice Address |
4190 Collins Way Lake Oswego OR 97035-3448 |
| Practice Telephone | 5036360966 |
| Practice Fax Number | 5036753552 |
| Mailing Telephone | 5036360966 |
| Mailing Fax Number | 5036753552 |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2020-11-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3140N1450X |
Skilled Nursing Facility Specialization: Nursing Care, Pediatric |
513068 | OR | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 513068 | 05 |
| Street Address |
4190 COLLINS WAY |
| City | LAKE OSWEGO |
| State | OR |
| Zip Code | 97035-3448 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700127 | Teresa Siebenaler Scott | Social Worker | 3990 Sw Collins Way, Suite 202, Lake Owsego, OR 97035 | 2020-11-04 |
| 1528671567 | Martin Henry Lees | Internal Medicine | 14 Morningview Lane, Lake Oswego, OR 97035 | 2020-08-28 |
| 1356976187 | Premere Rehab LLC | Occupational Therapist | Infinity Rehab - The Springs At Lake Oswego, 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2020-03-12 |
| 1689212193 | Jennifer Chauvin | Nurse Practitioner | 20 Juarez Street, Lake Oswego, OR 97035 | 2019-12-16 |
| 1003396888 | Sarah Guenzburger | Physical Therapist | 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2018-08-21 |
| 1568964252 | Brett Johnson | Marriage & Family Therapist | 5655 Southwood Dr, Lake Oswego, OR 97035 | 2018-03-08 |
| 1912416561 | Michael Paul Long | Social Worker | 14523 Westlake Drive, Lake Oswego, Or 97035, Lake Oswego, OR 97035 | 2017-09-27 |
| 1467807859 | Misty Lohn | Nurse Practitioner | 5 Centerpointe Dr., Ste 600, Lake Oswego, OR 97035 | 2016-05-04 |
| 1326405473 | Kelsey Prince | Behavioral Analyst | 6400 Sw Rosewood St., Portland (lake Oswego), OR 97035 | 2016-01-20 |
| 1942683388 | Elizabeth Risberg Harrison | Massage Therapist | 190 Oswego Summit, Lake Oswego, OR 97035 | 2015-07-02 |
| Find all providers in zip 97035 | ||||
| Taxonomy Code | 3140N1450X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| Specialization | Nursing Care, Pediatric |
| A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558427955 | Friendship Health Center | Skilled Nursing Facility | 3320 Se Holgate Blvd, Portland, OR 97202-3459 | 2006-12-29 |
| 1104823236 | Garber Enterprises, Inc. | Skilled Nursing Facility | 1166 E 28th Ave, Eugene, OR 97403-1615 | 2005-07-05 |
| 1649348236 | Pinnacle Healthcare, Inc. | Skilled Nursing Facility | 1077 Gateway Loop, Springfield, OR 97477-1114 | 2006-12-01 |
| 1376625137 | Providence Health & Services-oregon | Skilled Nursing Facility | 830 Ne 47th Ave, Portland, OR 97213-2212 | 2006-10-20 |
| City | LAKE OSWEGO |
| Zip Code | 97035 |
Please comment or provide details below to improve the information on OCTAVIA M NIGHTINGALE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.